Provider directory accuracy and timely access to mammograms in California.

Provider directory accuracy and access to timely appointments are crucial determinants of health outcomes. However, to our knowledge, no studies have analyzed provider directory accuracies or network adequacy for mammograms, an important preventive service. We fill that gap using large-scale, random, and representative surveys of provider directories and timely access for all managed care plans in California for mammogram providers, obtained from the Department of Managed Health Care for 2018 and 2019 for commercial, ACA marketplace, and Medicaid plans with more than 33,000 observations. Directory inaccuracies ranged from a low of 23 percent to a high of 38 percent. Consumers were able to schedule appointments with specific providers within 15 days in between 59 percent to 73 percent of cases. Comparisons of accuracy and adequacy between the three markets (commercial, ACA, Medicaid) were inconsistent. Even with one of the nation's strictest and most well-resourced regulatory regimes for provider networks, our findings show substantial inaccuracies and inadequacies exist.

Qualitative assessment of online information available on accredited head and neck surgery fellowship programs.

BACKGROUND: The present study aims to assess the quality and availability of online information about fellowships accredited by the American Head & Neck Society (AHNS). METHODS: AHNS directory pages and institutional web sites of 50 AHNS-accredited fellowships were identified. Web pages were scored using 20 standardized criteria including general information, application information, alumni, surgical training, research, and quality-of-life. RESULTS: Median scores for AHNS directory pages and institutional web sites were 11 (range: 7-14) and 10 (4-15), respectively. Faculty listings, contact information, program location, number of positions, and breadth of surgical exposure were the most commonly listed criteria. Less common criteria included didactic schedule, protected academic time, previous research projects, year of accreditation, work-life balance, fellow selection criteria, interview information, and salary. CONCLUSIONS: The AHNS directory and institutional web sites are most comprehensive in general program information and details about surgical training. Information about the application process, work-life balance, and research opportunities were less common.

Potemkin Protections: Assessing Provider Directory Accuracy and Timely Access for Four Specialties in California.

CONTEXT: The accuracy of provider directories and whether consumers can schedule timely appointments are crucial determinants of health access and outcomes. METHODS: We evaluated accuracy and timely access data obtained from the California Department of Managed Health Care, consisting of responses to large, random, representative surveys of primary care providers, cardiologists, endocrinologists, and gastroenterologists for 2018 and 2019 for all managed care plans in California. FINDINGS: Surveys were able to verify provider directory entries for the four specialties for 59% to 76% of listings or 78% to 88% of providers reached. We found that consumers were able to schedule urgent care appointments for 28% to 54% of listings or 44% to 72% of accurately listed providers. For general care appointments, the percentages ranged from 35% to 64% of listed providers or 51% to 87% of accurately listed providers. Differences across markets related to accuracy were generally small. Medi-Cal plans outperformed other markets with regard to timely access. Primary care consistently outperformed all other specialties. Timely access rates were higher for general appointments than for urgent care appointments. CONCLUSIONS: Our finding raise questions about the regulatory regime as well as consumer access and health outcomes.

A Web-Based Geolocated Directory of Crisis Pregnancy Centers (CPCs) in the United States: Description of CPC Map Methods and Design Features and Analysis of Baseline Data.

BACKGROUND: Crisis pregnancy centers (CPCs) are nonprofit organizations that aim to dissuade people considering abortion. The centers frequently advertise in misleading ways and provide inaccurate health information. CPCs in the United States are becoming more medicalized and gaining government funding and support. We created a CPC Map, a Web-based geolocated database of all CPCs currently operating in the United States, to help individuals seeking health services know which centers are CPCs and to facilitate academic research. OBJECTIVE: This study aimed to describe the methods used to develop and maintain the CPC Map and baseline findings regarding the number and distribution of CPCs in the United States. We also examined associations between direct state funding and the number of CPCs and relationships between the number of CPCs and state legislation proposed in 2018-2019 to ban all or most abortions. METHODS: In 2018, we used standard protocols to identify and verify the locations of and services offered by CPCs operating in the United States. The CPC Map was designed to be a publicly accessible, user-friendly searchable database that can be easily updated. We examined the number of CPCs and, using existing data, the ratios of women of reproductive age to CPCs and CPCs to abortion facilities nationally and by region, subregion, and state. We used unadjusted and adjusted negative binomial regression models to examine associations between direct state funding and the number of CPCs. We used unadjusted and adjusted logistic regression models to examine associations between the number of CPCs by state and legislation introduced in 2018-2019 to ban all or most abortions. Adjusted models controlled for the numbers of women of reproductive age and abortion facilities per state. RESULTS: We identified 2527 operating CPCs. Of these, 66.17% (1672/2527) offered limited medical services. Nationally, the ratio of women of reproductive age to CPCs was 29,304:1. The number of CPCs per abortion facility was 3.2. The South and Midwest had the greatest numbers of CPCs. The number of CPCs per state ranged from three (Rhode Island) to 203 (Texas). Direct funding was associated with a greater number of CPCs in unadjusted (coefficient: 0.87, 95% CI 0.51-1.22) and adjusted (coefficient: 0.45, 95% CI 0.33-0.57) analyses. The number of CPCs was associated with the state legislation introduced in 2018-2019 to ban all or most abortions in unadjusted (odds ratio [OR] 1.04, 95% CI 1.01-1.06) and adjusted analyses (OR 1.11, 95% CI 1.04-1.19). CONCLUSIONS: CPCs are located in every state and particularly prevalent in the South and Midwest. Distribution of CPCs in the United States is associated with state funding and extreme proposals to restrict abortion. Researchers should track CPCs over time and examine factors that influence their operations and impact on public health and policy.

Grupos de pesquisa de avaliação em saúde no Brasil: um panorama das redes colaborativas / Research groups of health evaluation in Brazil: an overview of collaborative networks

RESUMO O objetivo deste estudo foi o de caracterizar os grupos de pesquisa registrados na área temática avaliação em saúde do Diretório do Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), segundo sua certificação, ano de formação, região e estado do País, instituição e linha de pesquisa. Por meio do levantamento de todos os grupos de pesquisa da área de avaliação em saúde do CNPq de 1976 a 2017, identificaram-se 385 grupos. Não foram analisados 30 grupos por terem sido excluídos (6,7%), serem inexistentes (0,8%) ou duplicados (0,3%). Estatística descritiva aplicada aos 355 grupos analisados revelou que estão presentes em todas as regiões do País com distribuição bastante desigual, havendo maior concentração na região Sudeste (42,8%), sobretudo no eixo São Paulo - Rio de Janeiro; os principais vazios se localizam nos estados do Amapá, Roraima e Rondônia. A linha de pesquisa mais frequente foi a de 'avaliação e monitoramento de intervenções em saúde'. O panorama dos grupos de pesquisa confirma a conhecida desigualdade brasileira na produção de conhecimentos, bem como a necessidade de se aprofundar a investigação sobre as redes colaborativas de pesquisa em avaliação e de se promover a equidade investigativa e de formação.

ABSTRACT The objective of the study was to characterize the research groups recorded in the Health Evaluation thematic area of the National Council for Scientific and Technological Development (NCSTD) directory, categorized per certification, year of inception, region and state of the country, institution and research line. By means of data retrieved from NCSTD' health evaluation area research groups from 1976 to 2017, we identified 385 groups. Of these, 30 groups could not be analyzed due to their exclusion from the database (6,7%), non-existence (0.8%) or double entry (0.3%). Descriptive statistics applied to the 355 groups revealed that they are present in all regions of the country, although very unequally distributed. There is a higher concentration in the Southeast region (42.8%), at the São Paulo - Rio de Janeiro axis, being the main voids located in the states of Amapá, Roraima and Rondônia. The most frequent research line respected 'evaluation and monitoring of health interventions'. The research groups' depiction confirmed the well-known Brazilian inequality in the production of knowledge, as well as the need both to deepen research on collaborative research networks under evaluation and to promote research and training.

Development and Use of the Leadership Competencies for Healthcare Services Managers Assessment.

Healthcare management as a profession continues to evolve as the field of healthcare delivery becomes more complex. In some countries, formal degree programs in healthcare management and related professional associations have helped to establish the field as a distinct profession with a defined body of knowledge. In other countries, the professionalization of healthcare management has not developed, or is in the early stages of development. Many of these Low and Middle Income Countries (LMIC) have no formal training programs or professional associations to help set and define minimum standards and competencies for the profession. In many countries, national associations have been created by healthcare managers for sharing knowledge, information, and expertise. While major differences exist in the contexts where healthcare managers operate around the world, all have a common responsibility to enhance the leadership and managerial capacity and capability of their membership as well as promote the profession they represent. In spite of these efforts by national professional organizations and various ministries of health, healthcare management has not been universally recognized around the world as a profession. The Leadership Competencies for Healthcare Services Managers (Global Competency Directory) framework developed by the International Hospital Federation's global consortium for healthcare management serves as a catalyst and resource for defining the skills, knowledge, and abilities needed for the healthcare management profession. This article documents the purpose, development, validation, and use of the framework.

Local AIDS task forces / coordinating bodies.

PIP: This directory of local acquired immunodeficiency syndrome (AIDS) task forces and coordinating bodies was prepared by the US Conference of Mayors to facilitate the exchange of ideas among localities. Cited in the directory are 142 bodies--including minority liaisons--from 37 states and the District of Columbia. Local AIDS task forces have been established as a means of organizing and coordinating community responses to AIDS in terms of health services, funding, and risk reduction health education. The Conference of Mayors AIDS program offers technical assistance on innovative and effective AIDS education programs and has been providing financial and technical guidance to such programs since 1985. This directory was prepared for the 2nd National Conference on the Prevention of Human Immunodeficiency Virus (HIV) Infection Among Racial and Ethnic Minorities in the US held in Washington, DC, in August 1988.^ieng

The business of demographics.

PIP: The emergence of "demographics" in the past 15 years is a vital tool for American business research and planning. Tracing demographic trends became important for businesses when traditional consumer markets splintered with the enormous changes since the 1960s in US population growth, age structure, geographic distribution, income, education, living arrangements, and life-styles. The mass of reliable, small-area demographic data needed for market estimates and projections became available with the electronic census--public release of Census Bureau census and survey data on computer tape, beginning with the 1970 census. Census Bureau tapes as well as printed reports and microfiche are now widely accessible at low cost through summary tape processing centers designated by the bureau and its 12 regional offices and State Data Center Program. Data accessibility, plummeting computer costs, and businessess' unfamiliarity with demographics spawned the private data industry. By 1984, 70 private companies were offering demographic services to business clients--customized information repackaged from public data or drawn from proprietary data bases created from such data. Critics protest the for-profit use of public data by companies able to afford expensive mainframe computer technology. Business people defend their rights to public data as taxpaying ceitzens, but they must ensure that the data are indeed used for the public good. They must also question the quality of demographic data generated by private companies. Business' demographic expertise will improve when business schools offer training in demography, as few now do, though 40 of 88 graduate-level demographic programs now include business-oriented courses. Lower cost, easier access to business demographics is growing as more census data become available on microcomputer diskettes and through on-line linkages with large data bases--from private data companies and the Census Bureau itself. A directory of private and public demographic resources is appended, including forecasting, consulting and research services available.^ieng

Demographic projections.

PIP: Official population projections in the United Kingdom are described. Information is provided on the methods of projection and the projections available for the constituent countries of the United Kingdom. Information is also provided on sub-national, household, and labor force projections and on unpublished results and special services available. Addresses from which the various projections can be obtained are included.^ieng

[Special issue in honor of Joao Lyra Madeira].

PIP: This issue contains a selection of papers by the late Joao L. Madeira which have been previously published in the Revista Brasileira de Estatistica, together with an obituary and an annotated bibliography of his works.^ieng